Sunday, November 10, 2013

By Amy Orciari Herman
Testosterone supplementation is associated with a significantly increased risk for cardiovascular events among older male angiography patients, according to a retrospective study in JAMA.
Researchers examined outcomes among some 8700 veterans who'd undergone coronary angiography and had total testosterone levels below 300 ng/mL. Some 14% began testosterone therapy (usually patch or injection) at a median 1.5 years after angiography.
At 3 years, the primary outcome — a composite of all-cause mortality, MI, and ischemic stroke — had occurred in 26% of the testosterone group and 20% of the untreated group. After adjustment for coronary artery disease and other confounders, the relative risk for the primary outcome was 30% higher with testosterone therapy.
Harlan Krumholz, a cardiologist with NEJM Journal Watch, commented: "Amid the onslaught of ads promoting testosterone, this study provides cautionary information — and reminds us that chasing surrogate outcomes, like testosterone levels, may actually cause harm. We need outcomes studies to understand better the safety of these products."
Mary Wu Chang, MD Reviewing Tinkle BT et al., Pediatrics 2013 Oct 132:e1059
Guidance on diagnosis, referral, and patient advising of these children.
Marfan syndrome, a multisystem connective tissue disorder affecting the ocular, musculoskeletal, and cardiovascular systems, occurs in 1 in 5000 individuals. Transmission is autosomal dominant, but one quarter of cases result from new mutations. Most cases are caused by defects in FBN1, the gene that encodes for fibrillin. The phenotypical spectrum is wide, and features can present at any age. These authors offer guidance on recognizing and managing Marfan syndrome in children.
Diagnosis is clinically based utilizing well-defined (revised Ghent) criteria. Aortic root aneurysm and ectopia lentis (dislocated lens) are considered the cardinal features. In the absence of family history, the presence of these two features is sufficient for the unequivocal diagnosis of Marfan syndrome. Genetic testing is reserved for patients in whom there is strong clinical suspicion but full criteria are missing. Because some features are age-dependent, children and adolescents may be categorized as “potential Marfan syndrome” and evaluated periodically in lieu of genetic testing.
Excessive linear growth of the long bones is characteristic. Patients are taller than expected given familial height (mean final height: males, 75 inches; females, 69 inches). Growth of tubular bones is accelerated, leading to disproportionate features, including arachnodactyly (long, slender fingers) and pectus excavatum/carinatum (sunken or protruding chest). Scoliosis occurs in over half of patients. Facial features can be variable, subtle, and evolve over time. Ocular manifestations include ectopia lentis, retinal detachment, glaucoma, and cataracts.
Cardiovascular complications — aortic dilation/rupture, aortic valve insufficiency, and pulmonary artery enlargement — are the major source of morbidity and mortality and require lifelong monitoring. Aortic dilation is progressive; it is usually discernible before age 18 but can occur at any age. Mitral valve prolapse with congestive heart failure is the leading cause of cardiovascular morbidity and mortality in young children.
Stretch marks and inguinal hernias are common, despite the slender habitus. Recurrent hernias or hernias at surgical repair sites are a hallmark of Marfan syndrome and other connective tissue disorders.
Contact and competitive sports, activity requiring “burst” movement (e.g., sprinting), and intense static exertion (e.g., weight-lifting) should be avoided due to high cardiovascular risk. High-impact sports (e.g., boxing) carry a high risk for ocular trauma.
Intelligence is normal, and life expectancy can approach normal range.
Mary Wu Chang, MD Reviewing Tinkle BT et al., Pediatrics 2013 Oct 132:e1059
Guidance on diagnosis, referral, and patient advising of these children.
Marfan syndrome, a multisystem connective tissue disorder affecting the ocular, musculoskeletal, and cardiovascular systems, occurs in 1 in 5000 individuals. Transmission is autosomal dominant, but one quarter of cases result from new mutations. Most cases are caused by defects in FBN1, the gene that encodes for fibrillin. The phenotypical spectrum is wide, and features can present at any age. These authors offer guidance on recognizing and managing Marfan syndrome in children.
Diagnosis is clinically based utilizing well-defined (revised Ghent) criteria. Aortic root aneurysm and ectopia lentis (dislocated lens) are considered the cardinal features. In the absence of family history, the presence of these two features is sufficient for the unequivocal diagnosis of Marfan syndrome. Genetic testing is reserved for patients in whom there is strong clinical suspicion but full criteria are missing. Because some features are age-dependent, children and adolescents may be categorized as “potential Marfan syndrome” and evaluated periodically in lieu of genetic testing.
Excessive linear growth of the long bones is characteristic. Patients are taller than expected given familial height (mean final height: males, 75 inches; females, 69 inches). Growth of tubular bones is accelerated, leading to disproportionate features, including arachnodactyly (long, slender fingers) and pectus excavatum/carinatum (sunken or protruding chest). Scoliosis occurs in over half of patients. Facial features can be variable, subtle, and evolve over time. Ocular manifestations include ectopia lentis, retinal detachment, glaucoma, and cataracts.
Cardiovascular complications — aortic dilation/rupture, aortic valve insufficiency, and pulmonary artery enlargement — are the major source of morbidity and mortality and require lifelong monitoring. Aortic dilation is progressive; it is usually discernible before age 18 but can occur at any age. Mitral valve prolapse with congestive heart failure is the leading cause of cardiovascular morbidity and mortality in young children.
Stretch marks and inguinal hernias are common, despite the slender habitus. Recurrent hernias or hernias at surgical repair sites are a hallmark of Marfan syndrome and other connective tissue disorders.
Contact and competitive sports, activity requiring “burst” movement (e.g., sprinting), and intense static exertion (e.g., weight-lifting) should be avoided due to high cardiovascular risk. High-impact sports (e.g., boxing) carry a high risk for ocular trauma.
Intelligence is normal, and life expectancy can approach normal range.
Dr. Paul Sax highlights a phase II study that yielded “pretty spectacular results” for treating hepatitis C in his HIV and ID Observations blog.
According to the results of a recent study, an interferon-free regimen — a fixed-dose combination of sofosbuvir and ledipasvir — has the potential to cure most patients with genotype-1 HCV infection. Although we should avoid overstating the importance of this particular treatment approach, says Dr. Paul Sax in HIV and ID Observations, there is reason to be “ecstatic” about these findings.
By Kelly Young
An HIV treatment regimen of dolutegravir plus abacavir-lamivudine is superior to a currently recommended combination pill, according to a phase III trial published in the New England Journal of Medicine.
In the manufacturer-conducted SINGLE study, roughly 850 treatment-naive patients were randomized to dolutegravir (an integrase inhibitor) plus abacavir-lamivudine or to efavirenz-tenofovir disoproxil fumarate-emtricitabine (EFV/TDF/FTC). After 48 weeks of treatment, the dolutegravir group had a higher percentage of patients with HIV-1 RNA levels under 50 copies per milliliter (88% vs. 81%). The number of adverse events was lower in the dolutegravir group.
In his blog HIV and ID Observations, Paul Sax writes: "Up until the SINGLE study, one could argue that EFV-based treatments — especially TDF/FTC/EFV — represented the gold standard against which all other regimens must compete. Has that now changed? I think it has."
By Kelly Young
An HIV treatment regimen of dolutegravir plus abacavir-lamivudine is superior to a currently recommended combination pill, according to a phase III trial published in the New England Journal of Medicine.
In the manufacturer-conducted SINGLE study, roughly 850 treatment-naive patients were randomized to dolutegravir (an integrase inhibitor) plus abacavir-lamivudine or to efavirenz-tenofovir disoproxil fumarate-emtricitabine (EFV/TDF/FTC). After 48 weeks of treatment, the dolutegravir group had a higher percentage of patients with HIV-1 RNA levels under 50 copies per milliliter (88% vs. 81%). The number of adverse events was lower in the dolutegravir group.
In his blog HIV and ID Observations, Paul Sax writes: "Up until the SINGLE study, one could argue that EFV-based treatments — especially TDF/FTC/EFV — represented the gold standard against which all other regimens must compete. Has that now changed? I think it has."
Robert W. Rebar, MD Reviewing Williams CL et al., N Engl J Med 2013 Nov 7; 369:1819
Risk for certain rare neoplasms may be modestly increased, but this must be confirmed in future studies.
Children born after assisted reproductive technology (ART) are at slightly increased risk for prematurity, low birth weight, and congenital malformations, but information about long-term risks for rare but serious diseases is sparse. In a population-based study, investigators linked data on all children born after ART in Britain from 1992 through 2008 with national registry data on childhood tumors to determine incidence of cancer before age 15 in these children compared with those in the general population during the same period.
The cohort consisted of 106,000 children born after nondonor ART (mean follow-up, 6.6 years). A total of 108 cancers were identified in this group compared with 109.7 expected cancers (standardized incidence ratio [SIR], 0.98; 95% confidence interval, 0.81–1.19). Risks for leukemia, neuroblastoma, retinoblastoma, central nervous system tumors, renal tumors, and germ cell tumors were not increased. Excess risks for hepatoblastoma (SIR, 3.64; 95% CI, 1.34–7.93) and rhabdomyosarcoma (SIR, 2.62; 95% CI 1.26–4.82) were observed, and were not associated with imprinting disorders. Hepatoblastoma was associated with low birth weight.
Robert W. Rebar, MD Reviewing Williams CL et al., N Engl J Med 2013 Nov 7; 369:1819
Risk for certain rare neoplasms may be modestly increased, but this must be confirmed in future studies.
Children born after assisted reproductive technology (ART) are at slightly increased risk for prematurity, low birth weight, and congenital malformations, but information about long-term risks for rare but serious diseases is sparse. In a population-based study, investigators linked data on all children born after ART in Britain from 1992 through 2008 with national registry data on childhood tumors to determine incidence of cancer before age 15 in these children compared with those in the general population during the same period.
The cohort consisted of 106,000 children born after nondonor ART (mean follow-up, 6.6 years). A total of 108 cancers were identified in this group compared with 109.7 expected cancers (standardized incidence ratio [SIR], 0.98; 95% confidence interval, 0.81–1.19). Risks for leukemia, neuroblastoma, retinoblastoma, central nervous system tumors, renal tumors, and germ cell tumors were not increased. Excess risks for hepatoblastoma (SIR, 3.64; 95% CI, 1.34–7.93) and rhabdomyosarcoma (SIR, 2.62; 95% CI 1.26–4.82) were observed, and were not associated with imprinting disorders. Hepatoblastoma was associated with low birth weight.

Tuesday, August 20, 2013

Data from National Center for Scientific Research (CNRS) Provide New Insights into Angiogenesis
By a News Reporter-Staff News Editor at Angiogenesis Weekly -- Fresh data on Angiogenesis are presented in a new report. According to news reporting out of Marseille, France, by NewsRx editors, research stated, "Neural stem cells are maintained in the adult brain, sustaining structural and functional plasticity and to some extent participating in brain repair. A thorough understanding of the mechanisms and factors involved in endogenous stem/progenitor cell mobilization is a major challenge in the promotion of spontaneous brain repair."
Our news journalists obtained a quote from the research from National Center for Scientific Research (CNRS), "The main neural stem cell niche in the adult brain is the subventricular zone (SVZ). Following demyelination insults, SVZ-derived progenitors act in concert with oligodendrocyte precursors to repopulate the lesion and replace lost oligodendrocytes. Here, we showed robust vascular reactivity within the SVZ after focal demyelination of the corpus callosum in adult mice, together with a remarkable physical association between these vessels and neural progenitors exiting from their niche. Endogenous progenitor cell recruitment towards the lesion was significantly reduced by inhibiting post-lesional angiogenesis in the SVZ using anti-VEGF blocking antibody injections, suggesting a facilitating role of blood vessels for progenitor cell migration towards the lesion. We identified netrin 1 (NTN1) as a key factor upregulated within the SVZ after demyelination and involved in! local angiogenesis and progenitor cell migration. Blocking NTN1 expression using a neutralizing antibody inhibited both lesion-induced vascular reactivity and progenitor cell recruitment at the lesion site."
Exercise may reduce heart disease risk in liver transplant recipients
By a News Reporter-Staff News Editor at Heart Disease Weekly -- New research reveals that metabolic syndrome-risk factors that can lead to heart disease and/or stroke-is common in liver transplant recipients, with rates highest at one year following the procedure. Findings published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, indicate that exercise could reduce complications from metabolic disease in patients post-transplantation.
The National Heart, Lung, and Blood Institute suggests that obesity, physical inactivity, and insulin resistance increase risk of metabolic syndrome. According to the NHLBI, patients who have three or more of the following metabolic clinical features would be diagnosed with metabolic syndrome:
• high triglyceride level
• abdominal obesity
New Findings from Loyola University in the Area of Encephalocele Reported
By a News Reporter-Staff News Editor at TB & Outbreaks Week -- Investigators publish new report on Nervous System Diseases and Conditions. According to news reporting out of Maywood, Illinois, by NewsRx editors, research stated, "Spontaneous cerebrospinal fluid (CSF) otorrhea due to tegmen tympani defects can result in hearing impairment and predispose to meningitis. Seizures or neurological deficits are additional risks, particularly when associated with an encephalocele."
Our news journalists obtained a quote from the research from Loyola University, "Surgical repair of the dural defect through a middle cranial fossa (MCF) approach is a treatment option under these circumstances. This series describes eight individuals who presented with CSF otorrhea and MCF encephaloceles associated with conductive hearing loss. Defects in the tegmen tympani were noted in all patients on preoperative cranial imaging, and six of the eight patients had an associated encephalocele. The average age was 57 years (range 26 to 67) with a male: female ratio of 7:1. Most defects occurred on the left side (6 left/2 right). A standard MCF approach and repair of the dural defect with an autologous dural graft (Durepair or DuraGen, Medtronic, Minneapolis, Minnesota, USA) and a synthetic polymer glue (DuraSeal, Covidien, Mansfield, Massachusetts) was performed in each case with universal success. Resolution of the CSF otorrhea was noted in all cases. All cases but one ex! hibited an improvement in hearing. One patient developed a delayed methicillin-resistant Staphylococcus aureus meningitis 3 months after surgery that resolved with surgical re-exploration and antibiotic therapy. Facial nerve monitoring was standard. All patients exhibited normal facial function postoperatively. Prophylactic lumbar drain placement was only utilized in the first three patients.
Findings from International Medical University Update Understanding of Public Health
By a News Reporter-Staff News Editor at Vaccine Weekly -- A new study on Public Health is now available. According to news reporting out of Kuala Lumpur, Malaysia, by NewsRx editors, research stated, "(i) To determine knowledge of, and self-protecting preventive behaviours towards influenza A(H1N1)pdm09 and (ii) to identify the factors influencing intention to take influenza A(H1N1)pdm09 vaccination among the study population. This is a cross-sectional survey carried out in Mantin Town, a semi-urban area of Malaysia."
Our news journalists obtained a quote from the research from International Medical University, "A structured questionnaire consisted of sociodemographic characteristics, knowledge of pandemic influenza symptoms, mode of transmission, self-protecting preventive behaviours, and intention to receive the influenza A(H1N1)pdm09 vaccine was used for face-to-face interviews with the household members. Of 230 who heard about pandemic influenza A(H1N1), 86% had misconception about mode of transmission of influenza A(H1N1)pdm09, and 52% had sufficient self-protecting behaviours. A majority (58.3%; 134/230) had intended to receive the vaccine. In the multivariate analysis, the intention to get vaccinated was significantly higher among 'those who trusted in efficacy of vaccine for prevention of influenza A(H1N1)pdm09' (p <0.001), 'those who were equipped with higher education level' (p=0.015) and 'those who worry about themselves contracting illness' (p=0.008). Our findings highlig! ht the need to scale up the community's knowledge regarding influenza A(H1N1)pdm09."
Aligarh Muslim University Describes Findings in Bladder Cancer
By a News Reporter-Staff News Editor at Cancer Weekly -- New research on Bladder Cancer is the subject of a report. According to news originating from Aligarh, India, by NewsRx correspondents, research stated, "The interaction of environmental chemicals and their metabolites with biological macromolecules can result in cytotoxic and genotoxic effects. 4-Aminobiphenyl (4-ABP) and several other related arylamines have been shown to be causally involved in the induction of human urinary bladder cancers. The genotoxic and the carcinogenic effects of 4-ABP are exhibited only when it is metabolically converted to a reactive electrophile, the aryl nitrenium ions, which subsequently binds to DNA and induce lesions."


Our news journalists obtained a quote from the research from Aligarh Muslim University, "Although several studies have reported the formation of 4-ABP-DNA adducts, no extensive work has been done to investigate the immunogenicity of 4-ABP-modified DNA and its possible involvement in the generation of antibodies in bladder cancer patients. Human DNA was modified by N-hydroxy-4-acetylaminobiphenyl (N-OH-AABP), a reactive metabolite of 4-ABP. Structural perturbations in the N-OH-AABP modified DNA were assessed by ultraviolet, fluorescence, and circular dichroic spectroscopy as well as by agarose gel electrophoresis. Genotoxicity of N-OH-AABP modified DNA was ascertained by comet assay. High performance liquid chromatography (HPLC) analysis of native and modified DNA samples confirmed the formation of N-(deoxyguanosine-8-yl)-4-aminobiphenyl (dG-C8-4ABP) in the N-OH-AABP damaged DNA. The experimentally induced antibodies against N-OH-AABP-modified DNA exhibited much better recog! nition of the DNA isolated from bladder cancer patients as compared to the DNA obtained from healthy individuals in competitive binding ELISA."
Data from University of Edinburgh Provide New Insights into Genetic Research
By a News Reporter-Staff News Editor at AIDS Weekly -- Research findings on Genetic Research are discussed in a new report. According to news reporting from Midlothian, United Kingdom, by NewsRx journalists, research stated, "Multiple strain tuberculosis (TB) infections are now an acceptable facet of tuberculosis epidemiology. Identification of patients infected with more than one strain gives an insight in disease dynamics at individual and population level."
The news correspondents obtained a quote from the research from the University of Edinburgh, "This study therefore aimed at identifying multiple strain infections among TB infected patients. Furthermore, to determine factors associated with multiple strain infections in Mubende district of Uganda. A total of 72 Mycobacterium tuberculosis isolates from patients at Mubende regional referral hospital were characterized using 15 loci MIRU-VNTR, Spoligotyping and deletion analysis. Genotypic and epidemiological data were analyzed using MIRU-VNTR plus, Bionumerics software version 6.1 and an exact logistic regression model respectively. Eight (11.1%) of the 72 patients had mixed TB infections. Five were exclusively pulmonary mixed infections while three had both pulmonary and extra-pulmonary infections (Compartmentalized TB infections). Unlike previous studies that have linked this phenomenon to Beijing strains, multiple strains in this study belonged to T2-Uganda, X2 and T1 line! ages. Two of the pulmonary mixed infections were resistant to rifampicin or isoniazid. All except one were HIV positive, newly diagnosed cases and urban residents of Mubende district. The study revealed that one in nine urban dwelling, HIV/TB co-infected patient were infected with more than one M. tuberculosis strains."
Data from Research & Development Advance Knowledge in Mass Spectrometry
By a News Reporter-Staff News Editor at Pain & Central Nervous System Week -- Research findings on Mass Spectrometry are discussed in a new report. According to news reporting out of Lawrenceville, New Jersey, by NewsRx editors, research stated, "Research on disorders of the central nervous system (CNS) has shown that an imbalance in the levels of specific endogenous neurotransmitters may underlie certain CNS diseases. These alterations in neurotransmitter levels may provide insight into pathophysiology, but can also serve as disease and pharmacodynamic biomarkers."
Our news journalists obtained a quote from the research from Research & Development, "To measure these potential biomarkers in vivo, the relevant sample matrix is cerebrospinal fluid (CSF), which is in equilibrium with the brain's interstitial fluid and circulates through the ventricular system of the brain and spinal cord. Accurate analysis of these potential biomarkers can be challenging due to low CSF sample volume, low analyte levels, and potential interferences from other endogenous compounds. A protocol has been established for effective method development of bioanalytical assays for endogenous compounds in CSF. Database searches and standard-addition experiments are employed to qualify sample preparation and specificity of the detection thus evaluating accuracy and precision. This protocol was applied to the study of the histaminergic neurotransmitter system and the analysis of histamine and its metabolite 1-methylhistamine in rat CSF."
Biogen Idec has announced that its
EMPOWER Phase III ALS drug trial of
dexpramipexole has failed to meet its
primary endpoint.
Dexpramipexole, a treatment for amyotrophic
lateral sclerosis (ALS), did not meet its
primary endpoint of a joint rank analysis of
function and survival, and no efficacy was
seen in individual components of function or
survival, the drug company announced today.
... The trial also failed to show efficacy in its
key secondary endpoints. As such, Biogen
Idec has said it will abandon development of
dexpramipexole in ALS.
Biogen Idec Research and Development
executive vice president Dr Douglas Williams
said; "We share the disappointment of
members of the ALS community, who had
hoped that dexpramipexole would offer a
meaningful new treatment option.
"Nevertheless, the EMPOWER trial represents
a significant contribution to ALS research,
and Biogen Idec is committed to advancing
ALS science. We continue to work with
researchers around the world to understand
the causes of ALS and find potential
treatments for people with ALS."
The EMPOWER trial was a randomised,
double-blind placebo-controlled Phase III
trial of 943 people with ALS in 81 sites,
covering 11 countries. Patients were
randomised on a one-to-one basis to receive
either dexpramipexole or placebo.
Biogen Idec Neurodegeneration Clinical
Research director Dr Douglas Kerr said; "As
a physician who has treated people with ALS,
I hoped with all my heart for a different
outcome. While these results were not what
we expected, we hope these data will provide
a foundation for future ALS research."
The company intends to present detailed
results at a future medical conference.

Sunday, January 27, 2013

Suture production

All Sewn Up: Postcesarean Skin Staples vs. Subcuticular Sutures Subcuticular closure was associated with lower risk for wound complications.

As the cesarean delivery rate climbs, we are increasingly obliged to determine best practices for the procedure. In particular, averting wound-related complications would lower postcesarean morbidity considerably. Whether skin staples are better than subcuticular suture closure is not known; thus, investigators in Alabama conducted a randomized, controlled trial of the two methods in 393 women undergoing scheduled or unscheduled cesarean deliveries.

Regardless of maternal body-mass index (BMI; mean, 36 kg/m 2 ), women in the staple group were more likely than those in the suture group to suffer wound disruption or infection by 4 to 6 weeks postpartum (14.5% vs. 5.9%; relative risk, 2.5). Most complications consisted of wound disruption (RR, 3.8), and much of the difference in outcomes occurred before hospital discharge. Use of subcuticular closure added 10 minutes to median operating time (from 48 to 58 minutes; P <0.001). Patient-centered measures such as pain, cosmesis, and satisfaction did not differ between groups.

Comment: As we scrutinize the quality of care that we provide for its impact on patient safety and satisfaction, trials such as this are especially valuable. Although the study population was enriched for factors associated with wound complications (e.g., high body-mass index), the benefits of subcuticular closure persisted even in low-risk women (BMI <30, primary cesarean, no preceding chorioamnionitis). As the authors note, the costs associated with longer operative times are probably rivaled by costs associated with wound morbidity, the surgical stapler itself, and the time required to remove staples. This trial adds to the mounting evidence that subcuticular suturing is the best method for postcesarean skin closure.

Sunday, January 6, 2013

DISCUSSION ON RADIOISOTOPE & RADIOPHARMACEUTICAL: IT’S USES

RADIOPHARMACEUTICALS
Radiopharmaceuticals are drugs containing a radionuclide and are used routinely in nuclear medicine for the diagnosis and therapy of various diseases. Depending upon their medical applications radiopharmaceuticals are divided into two classes’ viz. diagnostic radiopharmaceuticals and therapeutic radiopharmaceuticals. They are briefly discussed below.
Diagnostics Radiopharmaceuticals
Diagnostic radiopharmaceuticals are molecules which are tagged with a gamma ray emitting radioisotope. Such agents when administered into the body localize in certain organs or tissue, for which they are designed for, and the radiation emitted by the associated radionuclide could be detected from outside with the help of suitable instrument like gamma camera. The analysis of the resultant images obtained from the gamma camera could reveal useful information regarding the disease condition of the patient.
Therapeutic Radiopharmaceuticals
Therapeutic Radiopharmaceuticals are very similar much to the diagnostic radiopharmaceuticals but the only difference being the use of a therapeutic radionuclide instead of a diagnostic radionuclide. In this case the primary aim is not to get diagnostic information but to deliver therapeutic doses of ionizing radiations to specific diseased sites. Further discussion on therapeutic radiopharmaceuticals is beyond the scope of present work. The various isotope used as therapeutic, diagnostic or research work are listed below in table-1 [6]
Isotopes used in radiopharmaceuticals with application
Table-1
ISOTOPE
t1/2
APPLICATION
198Au
2.7 d
Therapeutic
Diagnostic
14C
5700 Y
Research
45Ca
165 d
Diagnostic
47Ca
4.5 d
Diagnostic
57Co
270 d
Diagnostic
58Co
71 d
Diagnostic
60Co
5.27 y
Therapeutic
Diagnostic
51Cr
27.8 d
Diagnostic
121Cs
9.7 d
Diagnostic
137Cs
30 y
Research
18F
1.7 H
Diagnostic
3H
12.3 y
Diagnostic
Research
59Fe
45 d
Diagnostic
197Hg
2.7 d
Diagnostic
203Hg
46.9 d
Diagnostic
125I
60 d
Diagnostic
Therapeutic
131I
8.08 d
Diagnostic
Therapeutic
Research
113In
1.66 h
Diagnostic
192Ir
74.4 d
Therapeutic
42K
12.4 h
Research
99Mo
2.8 d
Source of 99mTc
22Na
2.6 y
Diagnostic
24Na
15 h
Diagnostic
32P
14.3 d
Diagnostic
Therapeutic
Research
226Ra
1620 y
Therapeutic
86Rb
18.8 d
Diagnostic
222Rn
3.8 d
Therapeutic
35S
88 d
Research
75Se
120 d
Diagnostic
85Sr
64 d
Diagnostic
90Sr
28 y
Therapeutic
182Ta
115 d
Therapeutic
99mTc
6.0 h
Diagnostic
90Y
2.6 d
Diagnostic
Therapeutic
169Yb
32 d
Diagnostic
65Zn
245 d
Research

The use of radioisotope in medicine is different upon the type of radiation emitted by it. Usually beta and gamma radiation are utilized for medical purpose because of the case with which they can be detected and measure.
Uses of radioactivity/radiation
There are many practical applications to the use of radioactivity/radiation. Radioactive sources are used to study living organisms, to diagnose and treat diseases, to sterilize medical instruments and food, to produce energy for heat and electric power, and to monitor various steps in all types of industrial processes.
Tracers
Tracersare a common application of radioisotopes. A tracer is a radioactive element whose pathway through which a chemical reaction can be followed. Tracers are commonly used in the medical field and in the study of plants and animals. Radioactive Iodine-131 can be used to study the function of the thyroid gland assisting in detecting disease.
Nuclear reactors
Nuclear reactorsare devices that control fission reactions producing new substances from the fission product and energy. Recall our discussion earlier about the fission process in the making of a radioisotope. Nuclear power stations use uranium in fission reactions as a fuel to produce energy. Steam is generated by the heat released during the fission process. It is this steam that turns a turbine to produce electric energy.
Other uses of radioactivity
Sterilization of medical instruments and food is another common application of radiation. By subjecting the instruments and food to concentrated beams of radiation, we can kill microorganisms that cause contamination and disease. Because this is done with high energy radiation sources using electromagnetic energy, there is no fear of residual radiation. Also, the instruments and food may be handled without fear of radiation poisoning.
Radiation sources are extremely important to the manufacturing industries throughout the world. They are commonly employed by nondestructive testing personnel to monitor materials and processes in the making of the products we see and use every day. Trained technicians use radiography to image materials and products much like a dentist uses radiation to x-ray your teeth for cavities. There are many industrial applications that rely on radioactivity to assist in determining if the material or product is internally sound and fit for its application. Radioactive isotopes have many useful applications. In medicine, for example, cobalt-60 is extensively employed as a radiation source to arrest the development of cancer. Other radioactive isotopes are utilized as tracers for diagnostic purposes, as well as in research on metabolic processes. When a radioactive isotope is added in small amounts to comparatively large quantities of the stable element, it behaves exactly the same as the ordinary isotope chemically; it can, however, be traced with a Geiger counter or other detection device. Iodine-131 has proved effective in locating brain tumours, measuring cardiac output, and determining liver and thyroid activity. Another medically important radioactive isotope is carbon-14, which is useful in studying abnormalities of metabolism that underlie diabetes, gout, anemia, and acromegaly. In industry, radioactive isotopes of various kinds are used for measuring the thickness of metal or plastic sheets; their precise thickness is indicated by the strength of the radiations that penetrate the material being inspected. They also may be employed in place of large X-ray machines to examine manufactured metal parts for structural defects. Other significant applications include the use of radioactive isotopes as compact sources of electrical power—e.g., plutonium-238 in cardiac pacemakers and spacecraft. In such cases, the heat produced in the decay of the radioactive isotope is converted into electricity by means of thermoelectric junction circuits or related devices
The present invention relates to a filamentous fungus useful for the production of heterologous polypeptides, having been... modified by recombinant DNA technology in a manner by which the expression of alkaline proteases have been completely or partially inactivated. The invention also encompasses processes for the production of proteins of interest in..

read more: http://www.pharmatutor.org/articles/isolation-extraction-purification-characterization-alkaline-protease-neurospora-crassa-enzyme-assay
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DISCUSSION ON RADIOISOTOPE & RADIOPHARMACEUTICAL: IT’S USES

INTRODUCTION
Radioactive nuclides, or radionuclides, are species of unstable atomic nuclei without the restriction of being forms of the same element. Radioactive nuclides consist of all the sets of radioactive isotopes. Radiochemistry a subdivision of chemistry which deals with the study of radioactive substances. it includes the nuclear transformation involved, transmutation of one element into another,and the nature and properties of the radiation emitted. it also deals with the use of this radiation in chemical tracer analysis, for geological & archeological (chemical dating), and for initiation of cross-lining(polymerazation)  [1] Spontaneous nuclear transformation of nuclide into another nuclide, accompanied by emission of nuclear radiation ,either corpuscular or electromagnetic. it may be natural, as with radium, artificial (caused bybombardment of a stable nucleus with neutrons or deuterons), or induced, as in radioactive carbon.the emanations are in the form of alpha, beta, gamma rays. the natural radioactive elements are uranium, radium, radon and thorium(the principal members of the uranium decay series), the ultimate end products being stable isotope of elements,e.g.,sodium,iodine etc., can be made radioactive by bombardment with neutrons, deuterons.or other heavy particles. Radionuclides, mainly 3H & 14C, are widely used as tracers in analysis, and in distribution and metabolism studies of drugs in animals.such isotope with long half-lives are not suitable for use in human medicine,but a number of radioisotopes with comparatively short half-lives, measured in hours or days,are now widely used in radiopharmaceutical preparations as diagnostic agents and in the treatment of neoplastic disease. these include 32P,51Cr,57Co,59Fe,75Se,125I.131I & 99mTc.  [2] Isotopes are generally distinguished by three analytical means. The first of them makes use of radioactive isotopes, such as tritium (3H), 14C, 32P etc. This is a highly sensitive technique, but special facilities are required to handle radioactive material. Mass spectroscopy can also be used to detect isotopes. This is also a highly sensitive technique. When the fragmentation pattern of a compound is known, mass spectral data provide a wealth of information. The third, and at present the most frequently used technique is nuclear magnetic resonance. This technique requires an NMR active nucleus such as 2H, 13C, 17O etc. and is relatively less sensitive. But the ease of operation more than compensates for its limitations.[3]
According to the different condition for storage ,handling,disposal and the manner in which the radionuclide are used they are categorized into two groups (1)sealed (2)unsealed. In radio therapy sealed radio isotope are used that are encapsulated to prevent the loss of the radioisotopes. On the other hand most radiopharmaceuticals are used in unsealed state. i.e. the radio isotope is present in the liquid , particular or gaseous state. These offers some hazards which include contamination by skin contact and accidental inhalation or ingestion.[4]

Types of radioactive isotopes by origin
1) Long-lived radioactive nuclides
Some radioactive nuclides that have very long half lives were created during the formation of the solar system (~4.6 billion years ago) and are still present in the earth. These include 40K (t½ = 1.28 billion years), 87Rb (t½ = 48.8 billion years), 238U (t½ = 447 billion years), and 186Os (t½ = 2 x 106 billion years, or 2 million billion years).
2) Cosmogenic
Cosmogenic isotopes are a result of cosmic ray activity in the atmosphere. Cosmic rays are atomic particles that are ejected from stars at a rate of speed sufficient to shatter other atoms when they collide. This process of transformation is called spallation. Some of the resulting fragments produced are unstable atoms having a different atomic structure (and atomic number), and so are isotopes of another element. The resulting atoms are considered to have cosmogenic radioactivity. Cosmogenic isotopes are also produced at the surface of the earth by direct cosmic ray irradiation of atoms in solid geologic materials.
Examples of cosmogenic nuclides include 14C, 36Cl, 3H, 32Si, and 10Be. Cosmogenic nuclides, since they are produced in the atmosphere or on the surface of the earth and have relatively short half-lives (10 to 30,000 years), are often used for age dating of waters.
3) Anthropogenic
Anthropogenic isotopes result from human activities, such as the processing of nuclear fuels, reactor accidents, and nuclear weapons testing. Such testing in the 1950s and 1960s greatly increased the amounts of tritium (3H) and 14C in the atmosphere; tracking these isotopes in the deep ocean, for instance, allows oceanographers to study ocean flow, currents, and rates of sedimentation. Likewise, in hydrology it allows for the tracking of recent groundwater recharge and flow rates in the vadose zone. Examples of hydrologically useful anthropogenic isotopes include many of the cosmogenic isotopes mentioned above: 3H, 14C, 36Cl, and 85Kr.
4) Radiogenic
Radiogenic isotopes are typically stable daughter isotopes produced from radioactive decay. In the geosciences, radiogenic isotopes help to determine the nature and timing of geological events and processes. Isotopic systems useful in this research are primarily K-Ar, Rb-Sr, Re-Os, Sm-Nd, U-Th-Pb, and the noble gases (4H, 3H-3He, 40Ar).
Because of their stable evolution in groundwater, such naturally occurring isotopes are useful hydrologic tracers, allowing evaluation of large geographic areas to determine flowpaths and flow rates. Consequently, they are helpful in building models that predict fracturing, aquifer thickness, and other subterranean features.
Production of radioisotope
Production of radioisotopes includes three principle categories, which are (1) neutron activation (bombardment), (2) fission product separation, and (3) charged particle bombardment. Nuclear bombardment constitutes the major method for obtaining industrially important radioisotope materials. Radioisotopes may exist in any form of matter, with solid materials comprising the largest group.
Emission of radioisotope
Three main type of radiation from radioactive substance are alpha(α),beta(β) and gamma(γ) rays.most source emit more than one type of emission, The penetrating power of each radiation varies considerably according to it’s nature and it’s energy. Alpha particle are completely absorbed in a thickness of a few micrometers to some tens of micrometer of solid or liquid. Beta particle are completely absorbed in a thickness of several millimeter to several centimeter. Gamma rays are not completely absorbed but only attenuated. The denser the absorbent , the shorter the range of alpha, beta particle and greater the attenuation of gamma rays.[5]
Cause of desirable effect of shorter half-lives radionuclide
In general, radionuclides (RN) with shorter half-lives are desirable for use in diagnostic nuclear medicine (NM) because they usually produce less total dose to the patient, thus yielding reduced biological impact compared to longer-lived radionuclides. Radionuclides that are selected for diagnostic NM procedures preferably emit photonic radiation (usually gamma rays) that have an energy in the approximate range from 100 to 150 keV. This energy is desirable since it is high enough to ensure reasonable penetration of the human body so that photons are able to reach the imaging device, usually a gamma camera; additionally this energy is detected with high efficiency by the detectors in the cameras and is low enough so that camera collimators work effectively to record primarily photons moving in a direction more-or-less perpendicular to the face of the detector. This is necessary in order to obtain acceptably sharp images without appreciable blurring. A final desirable property is that the radionuclide emits minimal amounts of particulate radiation such as beta particles and alpha particles so as not to produce excess patient dose while doing nothing to improve image quality. There are both long- and short-lived radionuclides that could fulfill these recommendations.
ABSTRACT:
Nanoparticle drug-delivery systems are the popular ones as are able to increase the selectivity and stability of therapeutic agents. However reticuloendothelial system (RES) uptake, drug leakage, immunogenicity, hemolytic toxicity, cytotoxicity, hydrophobicity restrict the use of these nanostructures. These shortcomings are overcome by surface engineering the dendrimer such as Polyester dendrimer, Citric acid dendrimer, Arginine dendrimer, Glycodendrimers, PEGylated dendrimers, etc.The field of Dendrimers has recently emerged as the most commercially viable technology of this century because of its wide-ranging potential applications in many fields such as: healthcare, electronics, photonics, biotechnology, engineering products, pharmaceuticals, drug delivery, catalysis, electronic devices, environmental issues and nanotechnologies. Dendrimer as a drug delivery agent is a promising, safe and selective drug delivery option.

ABSTRACT
Radioactive isotope, also called radioisotope,  any of several species of the same chemical element with different masses whose nuclei are unstable and dissipate excess energy by spontaneously emitting radiation in the form of alpha, beta, and gamma rays. Radioisotopes are elements that are atomically unstable and radioactive. Radioisotopes stabilize by releasing energy and matter. Natural radioisotopes, which have relatively low radioactive energy, have been largely replaced by artificially produced radioisotopes. Artificially produced radioisotopes are widely utilized as sources of radiation for radiography, gauging, and as tracers for a multitude of measurements that are not easily made by other methods. Radiopharmaceuticals are drugs containing a radionuclide and are used routinely in nuclear medicine for the diagnosis and therapy of various diseases. Presented article is concerned with brief discussion about the radioisotope & Radiopharmaceuticals.